Can you delay menopause with lifestyle or diet?
Avoiding smoking, eating less red meat, and eating more citrus fruit and oily fish appear to have a favourable influence on the age of menopause. However, evidence from controlled experiments is still entirely lacking.
Genetics is the strongest determinant of the age at which you reach menopause, but lifestyle and diet also matter. This is shown by large cohort studies, including a British one involving 3,566 women and an Australian one involving 1,146 women who were followed for an average of 12.5 years. Controlled experiments are virtually non-existent. Everything we know therefore consists of associations, not proven cause and effect.
Fish oil had the strongest association with a later menopause in the British study. Women who regularly took fish oil had a substantially reduced risk of early menopause. Vitamin B complex and vitamin C also showed a positive association, though less pronounced. Smoking and eating large amounts of red meat were associated with an earlier menopause.
One study drew attention to a substance that occurs naturally in mandarins, oranges and peaches. Women with a daily intake of approximately 400 micrograms of this substance reached menopause an average of 1.3 years later, even after adjusting for other factors. The mechanism has not yet been proven, but it suggests that eating more fruit may play a role.
Early menopause has broader consequences for your health. A Korean cohort study involving more than 1.1 million women showed that women whose menopause began before the age of forty had a 13% higher risk of type 2 diabetes than women whose menopause began at fifty or later.
Menopausal hormone therapy cannot delay menopause itself. A European expert guideline (EMAS) does state that it has a beneficial effect on blood sugar regulation after menopause. For women with diabetes and cardiovascular risk factors, a patch or gel containing oestradiol is preferred over an oestrogen pill. Whether hormone therapy is suitable for you must always be assessed individually by a doctor.
All findings come from cohort studies and association studies, supplemented by one expert guideline (EMAS). There are no controlled experiments demonstrating that any specific approach causally raises the age of menopause. The size of the studies ranges from 562 to more than 1.1 million women.
Does my weight and metabolism change during menopause?
During menopause, your body composition changes profoundly: more abdominal fat, less muscle and a lower resting metabolic rate. Exercise and nutrition demonstrably help, and discuss hormone therapy with your doctor as an additional option.
Can women preserve their fertility longer through lifestyle choices?
Lifestyle can influence your fertility, but genetics largely determines when you go through menopause. Avoid frequent heavy drinking, limit exposure to air pollution and hormone-disrupting substances, and consider folic acid supplements up to 800 mcg per day if you want to protect your fertility.
Which supplements actually help with menopause?
Red clover isoflavones and black cohosh have the strongest evidence for reducing hot flashes; soy isoflavones also help to some extent. For bone health, vitamin D is well supported. The effects are modest, and for severe complaints it is best to discuss the options with your doctor.
What helps against menopause symptoms like hot flushes and mood swings?
Hormone therapy works best against hot flushes and night sweats. Those who cannot or do not wish to use it can choose from proven non-hormonal medications and psychological therapy. Herbal supplements have no demonstrable effect.
Does the menopause disrupt my sleep, and what can help?
The menopause genuinely disrupts your sleep, primarily through hot flashes and hormonal changes. Cognitive behavioural therapy for insomnia (CBT-I) is the best first step; hormone therapy or melatonin may come into the picture after that.
What does menopause do to your risk of cardiovascular disease?
Menopause demonstrably increases your risk of cardiovascular disease, primarily through unfavourable changes in fat distribution, cholesterol, and blood pressure. If you experience early menopause or are considering hormone therapy, discuss your personal risk profile with your doctor.